December 29, 09

NEWS / Michigan Health Care Provider to Pay United States $669,413 to Settle False Claims Allegations

WASHINGTON – Genesys Health System has agreed to pay the United States $669,413 to settle a lawsuit alleging that the health care provider violated the False Claims Act by submitting false claims to Medicare, the Justice Department announced today.

Genesys, a Grand Blanc, Mich.-based company, provides health care services through a network of medical facilities located in Michigan. The government alleged that between 2001 and 2007, Genesys violated the False Claims Act by billing Medicare for higher levels of service than were actually rendered to patients. Specifically, the government alleged that Genesys overbilled for evaluation and management services provided to cardiology patients.

"As this case demonstrates, we are committed to vigorously pursuing those who defraud Medicare," said Tony West, Assistant Attorney General of the Justice Department’s Civil Division. "Taxpayer dollars should be spent on health care services for patients, not wasted on fraud and abuse." Assistant Attorney General West praised the coordinated efforts of the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Eastern District of Michigan, and the Office of Investigations for the Department of Health and Human Services’ Office of Inspector General and Office of Counsel to the Inspector General.

The allegations resolved by today’s settlement were initiated by a lawsuit filed under the qui tam or whistleblower provisions of the False Claims Act, which allow private citizens to sue for fraud on behalf of the United States and share in any recovery. The whistleblower in this case will receive a $133,882 share of today’s settlement.

"With the rising cost of health care and the related pressure on the Medicare Trust Fund, the last thing our nation can afford are providers who are profiteering at the expense of patients," said Terrence Berg, U.S. Attorney for the Eastern District of Michigan. "The relator can be proud that she brought these serious allegations of Medicare fraud to our attention and paved the way for the government to uncover the false claims. It is important that anyone who has information about alleged fraud on the federal government come forward so we can investigate."

The lawsuit was captioned as United States ex rel. Wendy Buterakos v. Ascension Health and Genesys Health System, Civil Action No. 06-10550 (E.D. Mich.).

http://www.justice.gov/opa/pr/2009/December/09-civ-1384.html